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2014 Health Benefits Open Enrollment May 1 – 23, 2014

Commonwealth of Virginia Health Benefits Program. 2014 Health Benefits Open Enrollment May 1 – 23, 2014. Highlights for July 1, 2014. April 2014. Customize based on your needs. Enroll, change or keep your health plan Consider buy-up options: COVA Care, COVA HealthAware & COVA HDHP.

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2014 Health Benefits Open Enrollment May 1 – 23, 2014

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  1. Commonwealth of Virginia Health Benefits Program 2014 Health Benefits Open EnrollmentMay 1 – 23, 2014 Highlights for July 1, 2014 April 2014

  2. Customize based on your needs • Enroll, change or keep your health plan • Consider buy-up options: • COVA Care, • COVA HealthAware & • COVA HDHP • Add or remove eligible family members • Waive coverage • Enroll in a Flexible Spending Account

  3. Your Health Plan Choices

  4. COVA Care and COVA HDHP Administered by Anthem and Delta Dental

  5. Anthemadministers: Medical BehavioralHealth EmployeeAssistanceProgram(EAP) PrescriptionDrug DeltaDentalpartners withAnthem forDental

  6. COVA Care and COVA HDHP Behavioral Health Change Effective 7/1/2014 • Residential Treatment Centers • Approved in-network behavioral health services

  7. www.AnthemEAP.com • Workplaceissues • Finance/Legal • Health and Wellness • Mentalhealth • Parentingand childcare • Marriage&relationshipconcerns

  8. COVA Care – Prescription Drugs • Change for 7/1/2014 • Drug copayments increase for tiers 2-4 • $5 retail/$10 mail Retail Tier Home Delivery $15 1 Generic drugs(nochange) $30 $ 60 2 Lowercost preferred brands $30 $45 $90 $60 3 Highercost brands $55 4 HighcostSpecialtybrand $110

  9. HomeDelivery Threemonthsupplyfor onlytwocopays Easytogetstarted onlineatanthem.com or byphone Deliveredsafelytoyour doorstep

  10. Optional Buy-Ups • ExpandedDental (Delta Dental) Out-of-Network ExpandedDental (Delta Dental) ◦ ◦ ◦ RoutineVision/ Hearing

  11. COVA Care – Vision and Hearing BlueViewVision • Eyeexam • Eyeglassesandcontactlenses • Frames • Discountsonaccessories ◦ ◦ ◦ • Hearing • Routinehearingexam • Hearingaids

  12. Anthem Tips and Resources Go tourgentcare centersinsteadof emergency rooms $25PCP/$40SpecialistcopayforUrgentCarevs.$150copay theER  at Call24/7NurseLine Accesstoaregisterednursedayornight  • Download the Mobile App on your smartphone • Find Doctor &Urgent Care Centers, View ID Card and Estimate Your Costs ◦ ◦ ◦  Usethe“EstimateYour Cost” tool Findcostrangesforservicesandqualityreviewsfordoctors  Bookmark yourdedicatedwebsite for Commonwealth employeesat anthem.com/cova 

  13. More on Dental Benefits Administered by Delta Dental of Virginia

  14. Delta Dental of Virginia will continue to administer the dental benefits for COVA Care and COVA HDHP • IMPORTANT PLAN FEATURES: • Diagnostic & Preventive services are covered at 100% for all members when they see a participating provider.

  15. Expanded Dental optional buy-up includes • Primary Care – such as fillings, extractions, root canals • Complex Restorative - dentures, bridges and implants • Orthodontic services

  16. COVA HealthAware Administered by Aetna Plan logo here

  17. Comprehensive Plan • Benefits and Coverage • Medical • Behavioral Health • Pharmacy • Basic Dental • Routine Vision Exam • Routine Hearing Exam • Includes a Health Reimbursement Account (HRA) • Expanded Dental and Vision benefits for an additional premium

  18. Changes for 7/1/2014 • Residential treatment centers added to behavioral health benefits. • More healthy activities to choose for “Do Right” contributions to the HRA.

  19. What is a Health Reimbursement Arrangement (HRA)? • Account that automatically pays eligible out-of-pocket expenses as long as funds are available • Medical • Behavioral health • Pharmacy • Funds paid automatically from HRA towards eligible expenses for any covered member • Unused HRA funds roll over into future plan years with no limit if enrollment in the plan continues

  20. COVA HealthAware HRA • The initial HRA contribution for 7/1/2014: • Employee/Retiree $ 600 • Employee/Retiree + Spouse $1,200 • HRA contribution is prorated for new enrollments or QME changes during the plan year. • The HRA proration chart may be found on www.COVAHealthAware.com

  21. HRA Contribution Employee/ Retiree only $600 Employee/Retiree + Spouse $1,200 Do Right HRA Incentives Employee/ Retiree only earn up to $150 Employee/Retiree + Spouse earn up to $300 In-Network Out-of-Network Deductible One person $1,500 $3,000 Two or more persons $3,000 $6,000 Out-of-pocket Max One person $3,000 $6,000 Two or more persons $6,000 $12,000 Coinsurance Preventive 100% 60% Diagnostic 80% 60% How the Plan Works COVA HealthAware is an open access, point-of-service (POS) plan with a large national network.

  22. HRA “Do Rights” • Employees/Retirees and enrolled spouses • Additional $50 HRA contribution for up to three “Do Rights” • Up to $150 per employee/retiree • Up to $150 per enrolled spouse • “Do Rights” include • Annual routine physical exam • Routine dental exam • Annual routine vision exam (new!) • Annual flu shot • Active Health Management Health Tracker • Active Health Management Coaching Module (new!)

  23. Pharmacy Benefits • Integrated with the medical benefit • Combined deductible and out-of-pocket maximum • Mandatory Generic plan • Specialty pharmacy available • Members can compare drug costs in advance on their member website

  24. Dental Benefits • Diagnostic and preventive dental services • Included with the basic plan • Covered at 100% in-network • Expanded Dental: Optional Buy-Up • Primary procedures: • fillings, extractions, root canals • Complex restorative procedures: • crowns, dentures, bridges, implants • Orthodontia

  25. Vision Benefits • Routine annual vision exam included with basic plan and covered at 100% • Expanded Vision: Optional Buy-Up • Materials benefit for eyeglasses and contact lenses • Discounts for eyewear and accessories • Network includes private practice providers plus participating national chains

  26. Employee Assistance Program (EAP)Aetna Resources For LivingSM • Available to participants and members of their household • Confidential resource to address and resolve personal and workplace challenges • Provides up to 4 visits per incident per plan year at no cost • Additional legal and financial guidance

  27. Member tools and resources Aetna Navigator • Secure member website for 24/7 plan access and answers to questions Member Payment Estimator • Provides real-time, personalized cost estimates for members based on their specific health plan and balances iTriage • Mobile app to help members make better healthcare decisions and improve healthcare delivery CarePass • Digital health and wellness tool to combine all leading health, wellness, and nutrition apps in one place Aetna Mobile • Access to Aetna Navigator from a smartphone

  28. Finding answers is easy! • Have a question about any COVA HealthAware Benefit? • One-stop, concierge-style service: 1-855-414-1901 • Dedicated website: www.COVAHealthAware.com

  29. MyActiveHealthTotal Population Health Program

  30. ActiveHealth Management: • Provides coaching services as part of the COVA health management program • Partners with Anthem and Aetna to • deliver services promoting healthy lifestyles and chronic condition management. Posters, flyers, postcards and email communications provide program information.

  31. Customized Health Portal www.myactivehealth.com/cova All eligible adult members may access their own customized portal Complete their health assessment Schedule biometric screening The portal is enhanced with online coaching and web tools Digital coaching Interactive trackers, games and more

  32. Healthy Lifestyles - Lifestyle Coaching with Five Tracks • Smoking Cessation • Weight Management • Stress Management • Nutrition • Exercise • Healthy Insights - Disease and Chronic Condition Management for Conditions Such As: • Heart Disease • Diabetes • Healthy Beginnings - Maternity Care

  33. Incentives - COVA Care and COVA HealthAware • Healthy Insights • Diabetes management • Hypertension (new July 1, 2014) • COPD & Asthma (new July 1, 2014) • Bariatric Surgery Coaching Program • Healthy Beginnings for expectant moms

  34. Kaiser Permanente HMO Administered by Kaiser Permanente

  35. New for July 1, 2014 • Pediatric Vision Eyewear up to age 19 • No cost to members • One pair of frames per year from select group, and • Certain single vision or bifocal lenses, or • Up to three months supply of contact lenses from selected list

  36. The Power of kp.org

  37. TRICARE SUPPLEMENT Administered by Association and Society Insurance Corporation (ASI)

  38. TRICARE SUPPLEMENT Voluntary supplemental health benefit option Available to employees and their dependents who are eligible for: TRICARE, the military health benefit program, and The State Health Benefits Program Eligible employees who enroll in the plan are responsible for 100% of the monthly premium amounts Monthly premium payments are made with pre-tax dollars through payroll deduction

  39. Premium Reward • For employee, retiree and/or enrolled spouse • Employee/Retiree or spouse can save $17/month • Together can save $34/month

  40. Already Earning a Premium Reward? • Remain in COVA Care or COVA HealthAware • Reward will continue through June 30, 2015 • No additional actions required • New! Confirm your reward status on EmployeeDirect

  41. Earn Premium Rewards – • COVA Care and COVA HealthAware • Eligible members enrolled from July 1, 2013–March 1, 2014 • Health assessment and biometric screening must be completed and submitted by May 31, 2014. • Eligible members enrolled effective April 1–July 1, 2014 • Health assessment and biometrics must be completed and submitted byAugust 31, 2014. • Health assessment and biometric registration are available atwww.MyActiveHealth.com/covaor by telephone at 1-866-938-0349

  42. Flexible Spending Accounts Administered by Anthem

  43. Flexible SpendingAccounts HealthcareFSA Set asideupto $2,500per year,pre-tax, for eligible health expenses DependentcareFSA Set asideupto $5,000per year,pre-tax, for dependent day care expenses UsetheEliteBenefitCardforeligible Health FSA expenses

  44. FSA Change for 7/1/2014 • You must file claims within the three months after your coverage period ends • Including any documentation required to validate an outstanding FSA card transaction. • For Example, if your coverage period ends on 4/30/15, you must file by July 31, 2015.

  45. All Participants Should Register Online: Account Balances Direct Deposit Account Activity Statements Online Payments Important Information about your FSA: Participants must enroll each plan year in order to participate. If you enroll in COVA HealthAware, the HRA pays first. See Spotlight on Benefits for website and contact information.

  46. ALEX is back! ALEX is your online interactive assistant. He can advise you on what plan may be best for you. The final decision is still yours. Take a look at www.alexforcova.com

  47. Get More Details • Find information: • Spotlight or Retiree notification booklet • www.dhrm.virginia.gov • Your agency Benefits Administrator • Contact the plans

  48. Make Your Election! • Visit http://edirect.virginia.gov • Login and select “Health Benefits Enrollment and Information” • Or submit an enrollment form to your agency benefits office • Final answer due May 23!

  49. Remember, It’s Your Call! • Consider what’s best for you and your family • Choose your health coverage • Premium reward • Employees - Flexible Spending Account

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